Provider Demographics
NPI:1629190475
Name:TRU VISION INC
Entity Type:Organization
Organization Name:TRU VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-978-7504
Mailing Address - Street 1:11159 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11159 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3218
Practice Address - Country:US
Practice Address - Phone:713-978-7504
Practice Address - Fax:713-266-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2523TG152W00000X
TX02523TG332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019715401Medicaid
TX0A5666Medicare PIN
TX1629190475Medicare UPIN